The NHS should embrace Skype, apps and online tools so patients can avoid hospital visits – and time off work and school – while also saving the health service millions, a senior doctor has pleaded.

NHS England medical director Professor Stephen Powis calls on the health service to use more technology and innovation to reduce the thousands of unnecessary outpatient appointments carried out every day. The NHS has evolved and innovated to meet the changing needs of patients over the past 70 years, but it is “crucial” that it now looks at how it interacts with patients so it continues to provide the best possible care, he said.

In his foreword to a report on outpatient care by the Royal College of Physicians (RCP), Professor Powis said: “The outpatient system is older than the NHS and the time has come to grasp the nettle and use tech and other innovations to improve patients’ experience and care.

Outpatient appointments in England have doubled over the last decade to 118 million a year (Photo: Shutterstock)

“As part of the long-term plan for the NHS, it’s right we look at ways to cut unnecessary appointments, save thousands of journeys, reduce traffic and pollution and make the NHS more efficient.”

More areas should follow the London borough of Tower Hamlets, Professor Powis said, where a pioneering virtual e-clinic allowing GPs send questions on kidney patients direct to specialist consultants for a quick reply has eliminated the need for an outpatient appointment. Only one in five kidney referrals now go to hospital and this could generate savings of up to £1m across North-East London alone to be recirculated in the local NHS, he said.

Environmental impact

The report suggests outpatient appointments should become more patient-centred, meaning there should be a clear health benefit when asking people to travel to appointments and take time off work and school. Transport to and from outpatient clinics has an impact on the environment, and in turn on public health, it points out, with 5 per cent of UK traffic each day NHS-related.

Outpatient appointments in England have doubled over the last decade to 118 million a year, but one in five potential appointments is cancelled or reported as “did not attend”, with the majority of cancellations instigated by the hospital. A survey of doctors by the RCP found a quarter said up to 20 per cent of their new patients did not need to come to outpatients.

Ending unnecessary appointments will also mean patients do not have to pay for travel or childcare, while it will free up clinical specialists to spend more time with complex patients, the report suggests. It said outpatient appointments account for 85 per cent of hospital activity, excluding A&E, and demand for appointments is outstripping the growth of the UK population.

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